Organizational structure
Fifth week
Prepared by Dr. Mohammad Barahemah
Introduction:
 To understand how the organization in which you are
employed is structured. You need to ask these questions:
To whom do I report?
To whom can I delegate?
To whom do I go with a problem or concern?
How do I report error?
Who will evaluate me ?
Am I responsible for evaluating someone else?
These and many other questions are answered by
understanding the organization’s structure and function
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Organization
 Define as a formally constituted group of people who
have identified tasks and who work together to achieve
a specific purpose defined by the organization.
 Organizational structure refers to the way in which a
group of people is formed, its lines of communication
and its means for channeling authority and making
decisions.
Prepared by Dr. Mohammad Barahemah
Formal and informal structure
 Formal: Through departmentalization and work division,
provides a framework for defining managerial authority,
responsibility, and work division.
 Informal structure: is generally social, with blurred or
shifting lines of authority and accountability.
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Organizational Theory
 Max Weber 1920s (father of organizational theory).
 He place high value on bureaucracy (the
administration of institutions through departments or
subdivisions managed by sets of officials who followed
an inflexible routine) and it’s importance in the
operation of an organization.
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Characteristics of Bureaucracies
 There must be a clear division of labor (work must be
divided into units).
 A well-defined hierarchy of authority must exist.
 There must be impersonal rules and impersonality of
interpersonal relationships.
 A system of procedures for dealing with the work
situation.
 A system of rules covering the right of each position.
 Selection and promotion is based on technical
competence.
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Modernized theorists
 Weber’s work did not, consider the complexity of managing
organization in the 21st century.
 Management theorists have learned much about human
behavior, and most organizations have modified their
structures and created alternative organizational designs that
reduce the rigidity and impersonality.
 A recent studies found that a significant relationship between
organizational structure and job satisfaction.
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Organizational structure
 Organizational chart: Is a picture of an organization to show
the organizational structure.
 An organization chart can help in identify roles and
expectations.
 Manager who understand an organization’s structure and
relationship will be able to expedite decision and have a
greater understanding of the organizational environment.
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Sample:
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Relationships and chain of command
 Solid horizontal lines: represent communication between
people with similar sphere of responsibility and power
but different in function.
 Solid vertical lines: denote the official chain of
command (unity of command). Best described by boss
 Those having the greatest decision making authority are
located at the top; those with the least are at the
bottom.
Prepared by Dr. Mohammad Barahemah
Relationships and chain of command
 Dotted line: represent advisory position, staff member
provide information and assistance to the manager but
has no organizational authority.
 Nurses frequently feel as though they have many bosses
because health care involve multidisciplinary approach.
 Weber indicates that a lack of unity of command results
in some conflict and lost productivity.
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Advantage and disadvantages of
chart
 Map lines of decision-making
 Show only formal relationships.
 Help people understand
assignments
 Does not degree of authority
 Reveals to managers how they fit
in the organization.
 Contribute to sound organization
structure
 Show formal line of
communication
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 My show things as they suppose
to be rather than as they are
 Possible exists of confusing
authority with status.
Span of control
 Span of control: means the number of individuals a person is
responsible for managing
 A narrow span of control: the individual will be responsible for
only a few people and perhaps one or two task areas
this individual is likely to be an expert
in the task area (IV therapy)
Wide span of control: if given responsibility for the IV team, the
emergency dept., and the staffing office,----this person could
not possibly be a clinical expert in every area and it is
unlikely to be involved in providing direct care in those
departments.
Prepared by Dr. Mohammad Barahemah
Managerial Levels
 Top-level: CEO (Chief operating officer), chief nursing
officer; determine the organization philosophy, setting
policies, and creating goals and priorities.
 Middle-level: Supervisor, head nurse; integrate unit level
day-to-day needs with organization needs.
 First-level: Charge nurse, team leader; focus primarily on
day-to-day needs at unit level.
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Centrality
 Where a position falls on the organization chart, is determine
by organizational distance.
 Employee with relatively small organizational distance can
receive more information that those who are more
peripherally located.
 This is why a middle manager has a large degree of centrality
because this manager receive information upward,
downward, and horizontally.
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Job descriptions



1.
2.
It is a written statements, found in policy manuals that
describe the duties and functions of the various jobs
within the organization.
They outline the scope of authority, responsibility, and
accountability involved in each position.
It should provide
the broad general guidelines under which the
individual will function
the basis for performance evaluation of the person
working in that role
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Types of organizational structure
 Line structures: Bureaucratic organization in which
authority and responsibilities are clearly defined, which
leads to efficiency and simplicity of relationship.
 Advantage: Little stress with orienting people to these
organization; authority and responsibilities are clearly
defined.
 Disadvantage: difficult to adjust the change, restrict
upward communication.
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example, line structure
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Ad Hoc design
 To overcome the inflexibility of the line structure
organization.
 Is a modification of the bureaucratic structure and
sometime its used in temporary basis to facilitate
completion of a project within a formal line organization.
 Used to handle the increasingly large amount of
available information.
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Ad Hoc design
 Ad hoc structures use a project team or task approach
and are usually disbanded after a project is completed.
 Disadvantage are decrease strength in the formal chain
and decreased employee loyalty to the parent
organization.
Prepared by Dr. Mohammad Barahemah
Matrix Structure
 Has formal vertical and horizontal chain of command. Is
designed to focus on both Product and Function.
 Function is describe all the tasks required to produce the
product, and products is the end results of the function.
 Has less formal rules and fewer level of hierarchy, but
decision making can be slow and could be source of
confusion and frustration.
Prepared by Dr. Mohammad Barahemah
Example: Matrix Structure
President
Functional manager
Vice president
of nursing
service
Product manager
Vice president
pediatric
service
Manager of
nursing
pediatric
Vice president
women service
Manager of
nursing women
service
Vice president
oncology
Manager of
oncology nurse
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Vice president of
Finance
Vice president of
human resources
Service Line organization
 Care-centered organization are smaller scale than large
bureaucratic system.
 Used in some large institution to address the shortcoming
that are endemic to traditional large bureaucratic
organization.
 For example, in this organization design, the overall goals
would be determined by the larger organization, but the
service line would decide on the processes to be used
to achieve the goals.
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Example: service line
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Flat design
 Are an effort to remove the hierarchical layers by flatting
the chain of command and decentralization the
organization.
 In flatten organization, there continues to be line
authority, but because the organizational structure are
flattened, more authority and decision making can
occur where the work is being carried out.
Prepared by Dr. Mohammad Barahemah
example, Flat design
Chief Nursing
manager
Nurse
manager
Nurse
manager
Nurse
manager
Nurse
manager
Staff
Staff
Staff
Staff
Prepared by Dr. Mohammad Barahemah
Decision Making within the organization
hierarchy
 Scalar chain or decision making hierarchy represent
where decision are made within the management
hierarchy.
 Centralized decision making- a few manager at the top
level make the decision.
 Decentralized decision making- diffuse decision making
throughout the organization.
 That allow the problem to be solved at the level which
they occur.
Prepared by Dr. Mohammad Barahemah
Decision Making within the organization
hierarchy
 Decision making need to be decentralized in large
organization because the complex questions that must
be answered can be best addressed by people with
distinct of experience.
 Leaving such decision in large organization to few
managers burdens those managers and could results
devastating delays in decision making.
Prepared by Dr. Mohammad Barahemah
Organizational Culture
 Is the total of an organization values, language,
traditions, and customs.
 Organizational culture vs organizational climate.
 Building a constructive culture requires the interpersonal
and communication skills of a leader.
 Large organization has sub-cultures.
Prepared by Dr. Mohammad Barahemah
Dimensions of organization culture
 Organizational physical environment (space, location,
condenses)
 Organization social environment (friendship, respect)
 How supportive is the organization
 Organizational power structure (who hold power)
 Organization safety
 Communication environment
Prepared by Dr. Mohammad Barahemah
Shared Governance:
 One of the most innovative and idealistic organization
structure.
 In shared governance, the organization is shared among
board members, nurses, physicians, and management.
 The decision making and communication channels are
altered.
 Its increase nurses’ authority and control over nursing
practice.
Prepared by Dr. Mohammad Barahemah
Organizational effectiveness
 There is no “best” way to structure an organization.
 Variables such as the size, the capability of its human
resources, and the commitment levels of the workers
should always be considered.
 Regardless of what type of organization structure is used,
certain minimal requirements can be identified:
1. The structure should be clearly defined
2. The goal should be to build the fewest management
level and have the shortest chain of command.
Prepared by Dr. Mohammad Barahemah
Cont…
3. The unit staff need to be able to see where their tasks fit into
common tasks of the organization.
4. The organization structure should enhance, not impede
communication.
5. The organization structure should facilitate decision making
that results in the greatest work performance.
6. Staff should be organized in a manner that encourage
informal group to develop a sense of community and
belonging.
7. Nurses services should be organized to facilitate the
development of the future leaders.
Prepared by Dr. Mohammad Barahemah
Thank You
Prepared by Dr. Mohammad Barahemah